Private Party

Application for use of the Meeting Room for a Private Party. Use this application for personal use of the meeting room, i.e. shower, graduation, birthday, anniversary, etc.

Please fill out the following information and click submit to email. The cost for a Private Party Use is $20.00. Please make check payable to Lake City Public Library and bring your money in on or before the requested date.

Your Email Address
Make sure you enter a valid email address. A confirmation email will be sent to you at this address.

Date of Meeting and Starting Time

Year/Month/DayHour:MinuteAM/PM

Ending Date and Time of Meeting

Year/Month/DayHour:MinuteAM/PM

Function or Activity
Please enter the general purpose of the meeting

Number Attending (estimate)
Please enter the estimated number of people attending your function

The person requesting this form agrees to assume entire responsibility and liability for all damages or injuries to all persons arising out of, resulting from, or in any manner connected with the above use of city facilities, and agrees to indemnify and save harmless the city, its agents and employees from all such claims including liable and legal fees and disbursements paid or incurred to enforce the provisions of this paragraph.

Contact Person Responsible for Care and Clean-up

Contact Phone Number
Please enter the phone number of the responsible person. Ex: 712-555-5555

Refreshments served?
Please select one.

YesNo

Media Equipment Needed
Please select any of the following that you will need for your function

Internet Connection

DVD Player

CD Player

Projector

Laptop (Windows only)

Microphone

Comments

Date Request Submitted

Year/Month/Day

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